CRIME SCENE INVESTIGATION PARTNERING FORENSICS WITH TRAUMA CARE
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1 Rocky Mountain Rural Trauma Symposium September 25, 2015 CRIME SCENE INVESTIGATION PARTNERING FORENSICS WITH TRAUMA CARE Lee Johnson, Supervisory Agent Montana Division of Criminal Investigation Major Case Section
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3 COLLECT E V I D E N C E PROTECT PRESERVE Transport IDENTIFY Hospital Scene ANALYZE ADJUDICATE Crimes of Violence
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6 Ammunition/Components
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10 Weapon contact
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12 12 Ga. 00 Buck 4 m t
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14 COLLECT E V I D E N C E PROTECT PRESERVE Transport IDENTIFY Hospital Scene ANALYZE ADJUDICATE Crimes of Violence
15 PRESERVE AND PROTECT
16 First Responders- Crime Scene Presence Assure Safety of all EMS Providers. Summon Law Enforcement if not already present. Lead EMT request entry of safe area to determine viability of patient. Summon resources only as absolutely necessary for patient care. Enter and exit scene in same path. Touch nothing along the way and only any items necessary to render patient care. Wear gloves at all times, prior to entry, do not remove until exit. Glove changes between patients and sources of evidence. Consider shoe covers Avoid pools of blood Do not cut clothes through knife or bullet holes. Do not go through patients personal effects. If hanging, do not untie or cut through knots of ligature.
17 70%
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19 McLane Shooting 6/2/06
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21 DAVIS SHOOTING 1
22 DAVIS SHOOTING 2
23 Davis Statements- Hospital I was drunk in the bar, somebody called me a name, I got a gun and just started shooting people. I couldn t see who I was shooting. I don t even remember that night, then when I got up the next day I was no way in hell going to turn myself in. I did kill some people over there then I killed some cops. No, I just shot the hell out of them. That body armor is the way to go. That other cop was behind me and I slammed on my brakes and he slammed into me and my car went way up into the air. I did really know what I was doing that night. The next morning I just wanted to get the hell out of Dodge.
24 COLLECT E V I D E N C E PROTECT PRESERVE Transport IDENTIFY Hospital Scene ANALYZE ADJUDICATE Crimes of Violence
25 COLLECTION Ideally, wet clothing from biological fluids should be air dried and packaged separately (per patient basis) Avoid cross-contamination between multiple patients Label packaged items Safely package sharp objects Bullets, fragments, fired casings in sturdy envelopes, bags or specimen containers- package separately per removal site. Follow hospital protocol for preserving sample fluids and retain if law enforcement interest anticipated. Pre-transfusion blood draws of interest to law enforcement. Re-inspect the work area and transport routes for evidence displaced in transit or medical care.
26 Montana Mandatory Reporting Laws for Health Care Providers- Criminal Activity Gunshot or Stab Wounds , MCA To a law enforcement officer by fastest possible means- written report within 24 hours after initial treatment or first observation (name and address of patient must be included) Suspected Cases of Child Abuse/Neglect , MCA To DPHHS or local affiliate promptlywritten report to include names and addresses of child, parent, or responsible persons. Content: Age, injuries, prior history, any helpful information/facts indicative of neglect or abuse. Suspected Abuse of the Elderly or Developmentally Disabled , MCA To DPHHS or local affiliate, County Attorney or Long Term Care Ombudsman if resident of a facility- oral or written as soon as possible. Content: Identifying information of both victim and suspect, prior history, any information relative to the nature and extent of abuse, sexual abuse, neglect or exploitation. *The law recognizes and provides healthcare professionals immunity from liability when reporting
27 Sexual Intercourse without Consent Voluntary by rape victim- If victim decides to report the assault at the time of exam the information becomes confidential criminal justice information and requires law enforcement action (confidentiality limiting the disclosure of victim identity protected under , MCA). If victim chooses not to report crime, information obtained at time of exam classified as medical information and falls under privacy protection.
28 Unraveling the Complexity Criminal Procedure vs. HIPPA / PHI Federal and State Constitution Reasonable Expectation of Privacy- Few Exceptions Consent/Exigent Circumstances/Search Incident to Arrest/Inventory/Caretaker Standard Procedure- Search Warrant or Investigative Subpoena
29 Health Insurance Portability and Accountability Act of 1996 (HIPPA) Criminal Procedure Parallels A patient or patient s representative must authorize disclosure of protected health information (valid consent) OR Disclosure of protected health information must fit a specific exception: Mandatory Reporting Imminent Danger Information that is necessary to identify or locate suspect (imminent danger element) Court Order- especially for patient physical items, biological samples, clothing, etc. Implied Consent for Blood/Alcohol- Patient is DUI Arrest, law mandates release
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32 Deceased Patients- Suspicion of Criminal Conduct Normally, deceased patients have a 50-year period of protection of health information to the same extent that HIPPA laws protect living individuals. 45 CFR Provisions permit a covered entity to disclose a decedent s health information to: Alert law enforcement to death, when death resulted from criminal conduct Coroners, Medical Examiners and Funeral Directors
33 Pronounce Death Determine Identity Notify Next of Kin Certify and Amend Death Certificates Order Autopsies Conduct Examinations and Tests Cause, Manner, Circumstances Issue Subpoenas Conduct Inquests Order Disinterment in furtherance of investigation Maintain Record of Inquiry Seize/Preserve Evidence
34 CORONER DUTIES CONT D (6), MCA If no law enforcement agency has jurisdiction in the case, preserve evidence involving any human death including personal and real property that may be related to or involved in the death , MCA Notify the county attorney and law enforcement agency having jurisdiction of all deaths caused or suspected to have been caused by: Criminal or suspected criminal act, medically suspicious, unusual or death of unknown circumstances, fetal deaths, accidental deaths, deaths by agent, disease or medical condition that pose a threat to public health, in-custody deaths, jail or prison deaths, some unattended deaths. A county coroner may enter any room, dwelling, building or other place he has probable cause to believe that a dead human body or evidence of circumstances of a death requires investigation. If refused entry, A coroner may apply for search warrant. The State Medical Examiner has jurisdiction over county coroners.
35 Preparation for arrival of Coroner When medical treatment and patient care stop; streamline involved personnel. Avoid any unnecessary touching of items at scene and back out. Prepare to brief coroner or law enforcement (discuss any documentation you may have) Leave medical apparatus in place If hospital move body to secure location (centralize clothing, evidence, personal effects) Develop best practices with local coroner and law enforcement.
36 Autopsy authority Generally speaking, if an autopsy is not required by law, it cannot be performed unless the deceased person s family gives permission , MCA (medicolegal investigation) All autopsies are within the discretion of the coroner based on opinion and when it is advisable to make inquiry into death. A county attorney or the Attorney General may require one if coroner does not. Must be performed by medical examiner or associate medical examiner.
37 Autopsy Triggers Death resulting from criminal or suspected criminal act Suicide Unattended death Police custody Death resulting from injury either recent or remote Death resulting from an accident Any suspicious/unusual death Death by an agent, disease, or medical condition posing health risk Death that occurred less than 24 hours after admission to medical facility or DOA Death of a hospital employee or visitor at hospital Suspected drug overdoses/poisonings.
38 DCI Major Case Contacts in Your Area: BOZEMAN- Major Case Supervisor Lee Johnson (office) (mobile) Agent Eric McLain BILLINGS- Agents Len Knutson and Marvin Dahl GREAT FALLS- Agents Mark Hilyard and Bruce McDermott HELENA- Agent Anthony Poppler BUTTE- Agent John Sullivan KALISPELL- Agent Kevin McCarvel
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